- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.13 / $169.82 / $169.82
| Facility | | $74.13 | $169.82 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $50.12 / $74.13
| Professional | | $42.66 | $50.12 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.92 / $31.62 / $213.80
| Professional | | $26.92 | $31.62 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $61.66 / $61.66
| Facility | | $61.66 | $61.66 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $199.53 / $316.23
| Facility | | $169.82 | $199.53 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $93.33 / $194.98
| Professional | | $70.79 | $93.33 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.36 / $213.80 / $363.08
| Facility | | $32.36 | $213.80 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.36 / $58.88 / $295.12
| Facility | | $32.36 | $58.88 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.90 / $37.15 / $112.20
| Professional | | $30.90 | $37.15 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $144.54 / $204.17
| Professional | | $79.43 | $144.54 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $123.03 / $295.12
| Facility | | $123.03 | $123.03 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $131.83 / $131.83
| Professional | | $131.83 | $131.83 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $338.84 / $338.84
| Professional | | $323.59 | $338.84 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $74.13
| Facility | | $50.12 | $50.12 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.30 / $37.15 / $120.23
| Professional | | $26.30 | $37.15 | $120.23 |